Masako Ono-Kihara

Bio: Masako Ono-Kihara is an academic researcher from Kyoto University. The author has contributed to research in topics: Population & Condom. The author has an hindex of 21, co-authored 73 publications receiving 1494 citations. Previous affiliations of Masako Ono-Kihara include Joint United Nations Programme on HIV/AIDS & International Institute of Minnesota.

Early initiation of sexual activity: a risk factor for sexually transmitted diseases, HIV infection, and unwanted pregnancy among university students in China

Abstract: To explore any association between the timing of the initiation of sexual activity and sexual behaviors and risks among university students in China. Data were derived from a cross-sectional study on sexual behavior among university students conducted in Ningbo municipality, China, at the end of 2003. Students completed a self-administered, structured questionnaire. Of 1981 sexually active male students, 1908 (96.3%) completed the item for timing of the initiation of sexual activity and were included in bivariate trend analyses and multiple logistic regression analyses to compare the association between this timing and sexual behavior and risks. Male early sexual initiators had a significantly higher risk profile, including a significantly higher proportion reporting non-regular partners (i.e., casual or commercial partners), multiple partners, diagnosis with a sexually transmitted disease (STD), partner history of pregnancy, partner history of induced abortion, and less condom and oral contraceptive use, compared with late initiators. Multivariate analyses confirmed the increased likelihood of these risks in early initiators versus late initiators, other than partner type during the last year. Our results showed that, compared to late initiators, people who initiated sexual activity early engaged in more risky behaviors that could lead to elevated risks of unwanted pregnancies and STDs or human immunodeficiency virus infection. Sex-education strategies should be focused on an earlier age, should include advice on delaying the age of first sexual activity, and should target young people who continue to take sexual risks.

High prevalence of HIV infection associated with incarceration among community-based injecting drug users in Tehran, Iran.

Abstract: The objectives were to determine the prevalence and correlates of HIV-1 infection among community-based injecting drug users (IDUs) in Tehran Iran. In October 2004 213 IDUs were recruited from a drop-in center and its neighboring parks and streets in Tehran. Participants were interviewed using a structured questionnaire regarding their sociodemographics and HIV risk characteristics and specimens of oral mucosal transudate were collected and tested for HIV-1 antibodies. Data were analyzed using x/2 and multiple logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI). The prevalence of HIV-1 infection was 23.2% (48 of 207) among male injecting drug users. In the multivariable analysis a history of shared drug injection inside prison (OR 2.45; 95% CI 1.01-5.97) and that of multiple incarcerations (OR 3.13; 95% CI 1.08-9.09) were associated with significantly higher prevalence of HIV-1 infection. The prevalence of HIV-1 infection has reached an alarming level among IDUs in Tehran with incarceration-related exposures revealed to be the main correlates of HIV-1 infection. Urgent and comprehensive harm reduction programs for drug users in prison and those in the community in Tehran are of prime importance to prevent further transmission of HIV infection. (authors)

Prevalence of and factors associated with HIV-1 infection among drug users visiting treatment centers in Tehran, Iran.

Abstract: This study was conducted to identify the prevalence of and potential risk factors for HIV-1 infection among drug users visiting drug treatment centers in Tehran Iran. Design: Cross-sectional quantitative study. Between October 2003 and May 2004 drug users who visited three public drug treatment centers in Tehran were interviewed and information about their sociodemographics drug use characteristics incarceration history sexual history and HIV/ AIDS knowledge and risk perception were collected. Specimens of oral mucosal transudate were then collected from participants to be tested for HIV-1 antibodies. Logistic regression analysis was conducted on the association between the demographic and behavioral factors with HIV-1 infection. Overall 611 (588 male and 23 female) drug users participated in the study. Among male injectors with HIV-1 prevalence of 15.2% a history of shared injection inside prison [adjusted odds ratio (OR) 12.37; 95% confidence interval (CI) 2.94– 51.97] was the main factor associated with HIV-1 infection. Among those who reported no history of injecting drug use HIV-1 prevalence was 5.4% and lack of condom use during sex was significantly associated with the infection (adjusted OR 3.42; 95% CI 1.25–9.36). HIV-1 infection is already prevalent among drug users in Tehran Iran and shared injection inside prison has been revealed to be a particular risk factor for HIV-1 infection among injecting drug users. Harm reduction programs which have been started in Iran should be urgently expanded particularly in correctional settings and strengthened by condom use promotion to prevent sexual acquisition or transmission of HIV-1 among drug users. (authors)

Needle and syringe sharing practices of injecting drug users participating in an outreach HIV prevention program in Tehran, Iran: a cross-sectional study.

Abstract: HIV infection rates have reached epidemic proportions amongst injecting drug users (IDUs) in Iran. Although a number of community-based interventions have being implemented in the country, there is little information on the risk behaviors of IDU participants in these programs. This cross-sectional report aimed to compare the risk behaviors of injecting drug users with differential exposure rates to an HIV outreach program in Tehran, Iran. Results indicated that shared use of needle/syringe in the past month was significantly lower among IDUs who received estimated ≥ 7 syringes per week than those who did not [adjusted odds ratio (OR) = 14.36, 95% confidence interval (CI) 2.30–89.56]. While the effectiveness of this outreach program needs further evaluation through a longitudinal investigation, our preliminary findings suggest that the outreach program in Tehran may have been beneficial in reducing direct sharing among those who received more than several needles/syringes from the program.

Food Insecurity Is Associated with Increased Risk of Non-Adherence to Antiretroviral Therapy among HIV-Infected Adults in the Democratic Republic of Congo: A Cross-Sectional Study

Abstract: BACKGROUND: Food insecurity is increasingly reported as an important barrier of patient adherence to antiretroviral therapy (ART) in both resource-poor and rich settings. However unlike in resource rich-settings very few quantitative studies to date have investigated the association of food insecurity with patient adherence to ART in Sub-Saharan Africa. The current study examines the association between food insecurity and adherence to ART among HIV-infected adults in the Democratic Republic of Congo (DRC). METHODS AND FINDINGS: This is a cross-sectional quantitative study of patients receiving ART at three private and one public health facilities in Kinshasa DRC. Participants were consecutively recruited into the study between April and November 2012. Adherence was measured using a combined method coupling pharmacy refill and self-reported adherence. Food insecurity was the primary predictor and was assessed using the Household Food Insecurity Access Scale (HFIAS). Of the 898 participants recruited into the study 512 (57%) were food insecure and 188 (20.9%) were not adherent to ART. Food insecurity was significantly associated with non-adherence to ART (AOR 2.06; CI 1.38-3.09). We also found that perceived harmfulness of ART and psychological distress were associated respectively with increased (AOR 1.95; CI 1.15-3.32) and decreased (AOR 0.31; CI 0.11-0.83) odds of non-adherence to ART. CONCLUSION: Food insecurity is prevalent and a significant risk factor for non-adherence to ART among HIV-infected individuals in the DRC. Our findings highlight the urgent need for strategies to improve food access among HIV-infected on ART in order to ensure patient adherence to ART and ultimately the long-term success of HIV treatment in Sub-Saharan Africa.

The Social Organization of Sexuality: Sexual Practices in the United States

Abstract: This survey of sexual practices in the United States has been combed by the media for items of interest to the public: monogamous sex is much more widespread in this country than has been thought; infidelity is less frequent than presumed; vaginal intercourse is the defining experience of heterosexual behavior; watching one's partner undress is stimulating to many people; married couples have more sex than single people (unmarried, cohabiting couples have the most sex of all); the majority of couples experience sex twice a week to several times a month; 2.8% of men identify themselves as homosexual and 1.4% of women do so, but a higher percentage of people consider a same-gender experience to have some appeal; 75% of men always experience orgasm compared with 28.6% of women, but more nearly equal numbers of men and women declare themselves satisfied with their sexual experiences. The book is, in fact, a

Impact of HIV-related stigma on treatment adherence: systematic review and meta-synthesis

Abstract: Introduction: Adherence to HIV antiretroviral therapy (ART) is a critical determinant of HIV-1 RNA viral suppression and health outcomes. It is generally accepted that HIV-related stigma is correlated with factors that may undermine ART adherence, but its relationship with ART adherence itself is not well established. We therefore undertook this review to systematically assess the relationship between HIV-related stigma and ART adherence. Methods: We searched nine electronic databases for published and unpublished literature, with no language restrictions. First we screened the titles and abstracts for studies that potentially contained data on ARTadherence.Then we reviewed the full text of these studies to identify articles that reported data on the relationship between ARTadherence and either HIV-related stigma or serostatus disclosure. We used the method of meta-synthesis to summarize the findings from the qualitative studies. Results: Our search protocol yielded 14,854 initial records. After eliminating duplicates and screening the titles and abstracts, we retrieved the full text of 960 journal articles, dissertations and unpublished conference abstracts for review. We included 75 studies conducted among 26,715 HIV-positive persons living in 32 countries worldwide, with less representation of work from Eastern Europe and Central Asia. Among the 34 qualitative studies, our meta-synthesis identified five distinct third-order labels through an inductive process that we categorized as themes and organized in a conceptual model spanning intrapersonal, interpersonal and structural levels. HIV-related stigma undermined ART adherence by compromising general psychological processes, such as adaptive coping and social support.We also identified psychological processes specific to HIV-positive persons driven by predominant stigmatizing attitudes and which undermined adherence, such as internalized stigma and concealment. Adaptive coping and social support were critical determinants of participants' ability to overcome the structural and economic barriers associated with poverty in order to successfully adhere to ART. Among the 41 quantitative studies, 24 of 33 cross-sectional studies (71%) reported a positive finding between HIV stigma and ART non-adherence, while 6 of 7 longitudinal studies (86%) reported a null finding (Pearson's x 2 7.7; p0.005). Conclusions: We found that HIV-related stigma compromised participants' abilities to successfully adhere to ART. Interventions to reduce stigma should target multiple levels of influence (intrapersonal, interpersonal and structural) in order to have maximum effectiveness on improving ART adherence.